On Jan. 31, 2011 the District Court of Northern Florida found the PPACA to be unconstitutional. The case was appealed, and on Aug. 12, 2011 the 11th Circuit upheld the ruling (2-1) that the PPACA was unconstitutional. The case was again appealed, and on Nov. 14, 2011 the US Supreme Court agreed to hear the case.

The case heard by the Supreme Court on Mar. 26-28, 2012 dealt with four main issues: 1. the constitutionality of the individual mandate portion of the PPACA which requires people to buy health insurance or pay a penalty; 2. the PPACA's mandated expansion of Medicaid; 3. whether or not the remainder of the PPACA can stand if the mandate is ruled unconstitutional (severability); and 4. whether or not the law can even be challenged before it takes effect in 2014 (Anti-Injunction Act).

Chief Justice Roberts stated that Congress cannot use its power to require people to buy insurance, but that the insurance mandate's "practical characteristics pass muster as a tax under our narrowest interpretations of [Congress's] taxing power." He wrote that a person who does not wish to purchase health insurance has "a lawful choice to do or not do a certain act, so long as he is willing to pay a tax levied on that choice."

Roberts struck down a provision of the Affordable Care Act that would have imposed a sanction on states which declined to expand Medicaid eligibility, stating that the provision "violates the Constitution by threatening existing Medicaid funding." The opinion stated that the remainder of the PPACA can stand despite the provision being ruled unconstitutional.

Senate Republican leader Mitch McConnell (R-KY) blasted the decision, stating: "Today's decision makes one thing clear: Congress must act to repeal this misguided law. Obamacare has not only limited choices and increased health care costs for American families, it has made it harder for American businesses to hire.”

Presidential candidate Mitt Romney has pledged to repeal the law if elected, saying in a statement: "If we want to get rid of Obamacare, we are going to have to replace President Obama... This is now a time for the American people to make a choice. You can choose whether to have a larger and larger government making intrusions into your life, or whether instead you want to return to a time where Americans have their own choice in health care."

Many provisions of the PPACA are already in effect. Most major provisions - including the tax on people who opt out of buying insurance - go into effect on Jan. 1, 2014. The law will be fully implemented with the elimination of the "Medicare gap" in 2020.

Sources:

CaspianX2, "What Exactly is Obamacare and What Did It Change?," reddit.com, June 20, 2012